PROMPT REMISSION OF POSTRENAL TRANSPLANT NEPHROTIC SYNDROME WITH HIGH-DOSE CYCLOSPORINE

A 2.8-year-old girl with focal segmental glomerulosclerosis had recurr ence of nephrotic syndrome within 3 days of renal transplantation and the serum creatinine increased. Renal biopsy showed cellular rejection and also complete effacement of the epithelial cell foot processes. T he rejection responded to methylprednisolone therapy but massive prote inuria persisted. An increase in the dose of cyclosporine A to 14 mg/k g per day was followed by immediate remission of the proteinuria. One month later, a second renal biopsy showed only focal fusion of foot pr ocesses. She remains free of proteinuria 2 years later. We propose tha t the higher dose of cyclosporine caused remission of the nephrotic sy ndrome.